PCOS

Question 1

PCOS diagnosis

Answer 1

At least 2 of the following:

Chronic anovulation
Clinical or biochemical signs of androgen excess
Polycystic ovaries in the absence of other metabolic disturbances

Question 2

PCOS risk factors

Answer 2

Family Hx, DM, insulin resistance, irregular menses or anovulation, IUD

Question 3

Signs/symptoms of PCOS: androgen excess

Answer 3

irregular menses, amenorrhea, oligomenorrhea, hirsutism, acne, alopecia

Question 4

Signs/symptoms of PCOS: metabolic

Answer 4

Obesity, insulin resistance, dyslipidemia, metabolic syndrome

Question 5

Signs/symptoms of PCOS: polycystic ovaries

Answer 5

12 or more follicles measuring 2-9cm in diameter or increased ovarian volume during ovarian phase

Question 6

Non-pharm treatment of PCOS

Answer 6

Increased physical activity, healthy diet, hirsutism can be treated with bleaching, plucking, shaving, electrolysis, Vaniqa 13.9% cream

Question 7

Pharm treatment of PCOS

Answer 7

CHC with norgestimate, desogestrel, or drospirenone as 1st line and not seeking pregnancy

Antiandrogens in patients not seeking fertility

Metformin (recommended in addition to clomiphene)

PO ovulation induction agents like clomiphene, letrozole (the first line in patients desiring improvements in fertility)

Injectable ovulation induction (gonadotropins), used in patients who’ve failed PO contraception for infertiltiy